The role of anxiety sensitivity in anger symptomatology: Results from a randomized controlled trial

Anger is often overlooked in the assessment and treatment of pathological anxiety, despite there being evidence that anger is elevated across all anxiety disorders. Anxiety sensitivity (AS), a major risk factor of anxiety disorders, has been shown to modulate anger in response to threat induced hyperarousal. The current study therefore examined if reductions in anxiety sensitivity (AS) mediate reductions in anger symptoms. Outcomes from a randomized control trial evaluating the efficacy of a brief AS mitigation intervention were analyzed. Patients with anxiety and comorbid conditions were randomly assigned to AS reduction (n = 58) or a repeated contact control condition (n = 60) and followed up with for three months. Analyses evaluated whether treatment related change in AS mediated later reductions in anger, hostility, verbal aggression, and physical aggression. Results revealed that reductions in AS temporally mediated the effects of treatment on later reductions in anger, hostility, verbal aggression, and physical aggression. Specificity analyses provided further support for the direction and specific variables examined in these models. Results suggest that AS may be a promising treatment target for anger symptoms among those with elevated anxiety symptoms.